Surgical treatment of epidermodysplasia verruciformis

Epidermodysplasia verruciformis (EV) is a genodermatosis, characterized by human papilloma virus infection, with polymorphic and disseminated lesions that develop malignant transformation in approximately half of patients.

We describe clinical and epidemiological features of 10 cases of EV during a 5-year period. All were treated using curettage of the nonmalignant wart-like lesions with a curette and application of 35% trichloroacetic acid (TCA) with a cotton bud for a few seconds.

Ten patients aged 33 to 67, nine women and one man, were treated, mainly presenting flat, brownish, wart-like lesions distributed on the anterior and posterior trunk. Two patients developed squamous cell carcinoma, histologically confirmed, that was surgically removed using fusiform excision. Good cosmetic results were obtained, and there was no reappearance of lesions during a mean follow-up of 3.5 years.

Curettage and application of 35% TCA that we have used in these patients has been shown to be an effective and low-cost alternative, compared to oral, topical, or other physical ablative therapies, with satisfactory cosmetic results and no recurrence during follow-up.